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Swallow Study for healthy 1 mo. old?

My DS is 4 weeks old and EBF. Since birth he has OCCASIONALLY coughed during feedings (maybe once or twice a day), but has always sounded a little raspy afterwards. I have OALD and a little bit of oversupply, but he has always handled feedings well (even with the air gulping, gas, etc). He is growing like a weed (thank you oversupply), has a great disposition and is healthy and happy. Due to the couging, his ped recommended a swallow study today. I am torn as to whether or not to go along with this. If the "professionals" decide he needs thicker milk, I will be instructed to stop feeding at the breast and exclusively pump and add a thickener to his milk. This recommendation would be devastating for me ... breastfeeding is so important to me and he is happy and healthy! But of course, I do not want to be causing any problems with aspiration either. I would love some input/perspective from other BFing moms with infants with swallowing difficulties, or infants who have had swallow studies done and their outcomes. (Since the recommendation today, I will be working on correcting the oversupply and positioning, for sure!)

This is my first post since bf'ing my now 4 year old, I really appreciate the replies! Thank you!

Re: Swallow Study for healthy 1 mo. old?

I would get it done. I'm an SLP and very pro-breastfeeding and I believe you should at least know what's going on. Pumping isn't going to be the only solution, and like you said, he's happy and healthy. Sorry I don't have personal experience with my child having a swallow study but I have seen plenty of them and I think it's good to at least see what's happening.

Re: Swallow Study for healthy 1 mo. old?

I think I'd look into a second opinion from a different doc before proceeding. Babies who struggle with oversupply and fast letdowns will often cough, gag, and splutter during feedings, so my feeling is that the swallow study could be overkill. Particularly for a healthy, happy, growing baby.

Is there any reason other than the coughing that would explain why the doc would suspect a swallowing issue?

Re: Swallow Study for healthy 1 mo. old?

I have decided to go ahead with the study, because I don't feel that the information from it will hurt anything. I do not think I would go with any recommendation to stop breastfeeding though, unless something was significantly wrong. Since yesterday I have pumped through two let downs before feeding him and have fed him almost completely laid back. No coughing and much less throaty-raspy sounds after feeding. I can't think of any other reason that he ordered the swallow study besides the cough (he certainly felt that the cough was reason enough).
On a related note, I have felt for awhile that his labial frenulum is tight. I mentioned that to the ped and he glanced at it, said "yes, somewhat" but that almost never interfered with feedings, he would outgrow it, etc. Funny, because quick internet research turns up many, many moms who have had breastfeeding difficulties due to tight labial frenulums that resolved or at least improved after having it clipped. And the same response was quoted by most of those moms when they initially questioned their peds as well. Although I don't know that a tight labial frenulum would have anything to do with coughing.
@krystine - do you have any experience with this problem? I really appreciate your input as an SLP, plus I don't know where to go from here...
Thanks!

Re: Swallow Study for healthy 1 mo. old?

I would ask the doctor again about the labial frenulum, although, be warned most aren't very experienced. Do you have any local friends who have had their babies frenulum clipped? (then find out who did it and see if you can see that doctor). My daughter had posterior tongue tie and we had it clipped although I can't say I noticed any difference in her ability to remove milk. It's really a quick procedure if you can find someone willing to clip it. I had mine done by a breastfeeding medicine specialist, and there are only 3 of those in the country, I believe (she's an MD who specializes in BF med). I really hope you get some answers and solutions soon!

Re: Swallow Study for healthy 1 mo. old?

I'm no expert, but it seems to me that anything that impacts tongue mobility has at least the potential to impact the baby's swallowing. A lot of babies will use their tongue to control milk flow from rapid letdowns, and a baby who is unable to move her tongue properly might be unable to keep milk from getting into her airway.

I was really curious after your post and went googling, and I found this interesting article on infant/child swallowing: http://www.appliedradiology.com/Issu...-children.aspx this was the part I found really interesting: "The clinical manifestations that prompt referrals for evaluation are not specific responses to an underlying cause. These include pulmonary signs and symptoms including recurrent pneumonias, difficult-to-control asthma, congestion and cough with feedings, apparent life-threatening episode, apnea, bradycardia, cyanosis with feedings, and persistent oxygen requirements. Gastrointestinal symptoms include poor weight gain and growth. Generalized manifestations of oral dysfunction include drooling and gagging, refusal to feed, messy eating, and tongue thrusting." The only thing on that list that matches with your baby is the congestion and cough.

Re: Swallow Study for healthy 1 mo. old?

Its definitely more of a swallowing issue (swallowing a lot of air, and also the coughing) than milk transfer. He is gaining great, although I think that has more to do with my oversupply than an excellent latch on his part. But we have an appt with a ped ENT, 3 days after our swallow study. Interested to hear his take on all of this. Pumping before he breastfeeds seems to have made the most difference but he still struggles some. Thanks for your responses. Hoping for some resolution that doesn't involve exclusive pumping...